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Seventeen New Cases of Chronic Ulcerative Stomatitis with Literature Review.
Head Neck Pathol. 2019 Sep; 13(3):386-396.HN

Abstract

Chronic ulcerative stomatitis (CUS) is a poorly understood disease with clinical and histologic overlap with lichen planus (LP). Unlike classic LP, direct immunofluorescence (DIF) studies in cases of CUS exhibit a granular pattern of IgG in nuclei of basal and parabasal cells. This study assesses the demographic, clinical, histologic, and DIF features of CUS. It is important to differentiate CUS from LP and other vesiculobullous diseases (VBD) because lesions of CUS are resistant to steroid therapy, which is typically used to control LP and VBD. A literature review and IRB-approved retrospective search of CUS was performed within the archives of the University of Florida (UF) Oral Pathology Biopsy Service from 2007 to 2017. Fifty-two cases were identified from the literature and seventeen new cases were identified in our series. All UF patients were female and the median age was 64-years. The majority of patients were Caucasian and the most common location was buccal mucosa. Frequent clinical presentations were pain, erythema, leukoplakia, and ulcerations. Histologic features included epithelial separation, atrophic epithelium, and a chronic inflammatory infiltrate. All cases were confirmed with DIF testing that showed a speckled pattern of IgG staining in basal and parabasal cell nuclei. Fibrinogen was present in eleven cases and two cases were positive for C3. The results of our series are in accordance with the literature. Since CUS has overlapping features with LP and VBD, clinicians and pathologists should consider this entity and confirm diagnosis with DIF testing when recalcitrant oral ulcerative diseases are encountered.

Authors+Show Affiliations

College of Dentistry, University of Florida, Gainesville, FL, USA. RReddy@dental.ufl.edu. University of Florida College of Dentistry, 1395 Center Drive, Room D8-6, Gainesville, FL, 32610, USA. RReddy@dental.ufl.edu.College of Dentistry, University of Florida, Gainesville, FL, USA.College of Dentistry, University of Florida, Gainesville, FL, USA.College of Dentistry, University of Florida, Gainesville, FL, USA.College of Dentistry, University of Florida, Gainesville, FL, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

30374883

Citation

Reddy, Rekha, et al. "Seventeen New Cases of Chronic Ulcerative Stomatitis With Literature Review." Head and Neck Pathology, vol. 13, no. 3, 2019, pp. 386-396.
Reddy R, Fitzpatrick SG, Bhattacharyya I, et al. Seventeen New Cases of Chronic Ulcerative Stomatitis with Literature Review. Head Neck Pathol. 2019;13(3):386-396.
Reddy, R., Fitzpatrick, S. G., Bhattacharyya, I., Cohen, D. M., & Islam, M. N. (2019). Seventeen New Cases of Chronic Ulcerative Stomatitis with Literature Review. Head and Neck Pathology, 13(3), 386-396. https://doi.org/10.1007/s12105-018-0982-7
Reddy R, et al. Seventeen New Cases of Chronic Ulcerative Stomatitis With Literature Review. Head Neck Pathol. 2019;13(3):386-396. PubMed PMID: 30374883.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Seventeen New Cases of Chronic Ulcerative Stomatitis with Literature Review. AU - Reddy,Rekha, AU - Fitzpatrick,Sarah G, AU - Bhattacharyya,Indraneel, AU - Cohen,Donald M, AU - Islam,Mohammed N, Y1 - 2018/10/29/ PY - 2018/07/30/received PY - 2018/10/26/accepted PY - 2018/10/31/pubmed PY - 2020/1/29/medline PY - 2018/10/31/entrez KW - Chronic ulcerative stomatitis KW - Direct immunofluorescence antibody technique KW - Histology KW - Oral pathology SP - 386 EP - 396 JF - Head and neck pathology JO - Head Neck Pathol VL - 13 IS - 3 N2 - Chronic ulcerative stomatitis (CUS) is a poorly understood disease with clinical and histologic overlap with lichen planus (LP). Unlike classic LP, direct immunofluorescence (DIF) studies in cases of CUS exhibit a granular pattern of IgG in nuclei of basal and parabasal cells. This study assesses the demographic, clinical, histologic, and DIF features of CUS. It is important to differentiate CUS from LP and other vesiculobullous diseases (VBD) because lesions of CUS are resistant to steroid therapy, which is typically used to control LP and VBD. A literature review and IRB-approved retrospective search of CUS was performed within the archives of the University of Florida (UF) Oral Pathology Biopsy Service from 2007 to 2017. Fifty-two cases were identified from the literature and seventeen new cases were identified in our series. All UF patients were female and the median age was 64-years. The majority of patients were Caucasian and the most common location was buccal mucosa. Frequent clinical presentations were pain, erythema, leukoplakia, and ulcerations. Histologic features included epithelial separation, atrophic epithelium, and a chronic inflammatory infiltrate. All cases were confirmed with DIF testing that showed a speckled pattern of IgG staining in basal and parabasal cell nuclei. Fibrinogen was present in eleven cases and two cases were positive for C3. The results of our series are in accordance with the literature. Since CUS has overlapping features with LP and VBD, clinicians and pathologists should consider this entity and confirm diagnosis with DIF testing when recalcitrant oral ulcerative diseases are encountered. SN - 1936-0568 UR - https://www.unboundmedicine.com/medline/citation/30374883/Seventeen_New_Cases_of_Chronic_Ulcerative_Stomatitis_with_Literature_Review L2 - https://dx.doi.org/10.1007/s12105-018-0982-7 DB - PRIME DP - Unbound Medicine ER -